Restoration of an upper premolar

on 1 December 2006

The patient highlighted in this article was a 20-year-old female with a clear medical history. She presented with a missing upper premolar which had been extracted two months earlier due to dental caries. The extraction was carried out with a view to replacing this tooth with a dental implant.

A standard plus aesthetic dental implant was placed under local anaesthetic in the region and allowed to heal for the initial eight-week post-op period as recommended by the placement protocol.

The healing cap was simply unscrewed and the soft tissues appeared healthy. A screw impression coping was used to record the implant’s position and an Impregum impression taken along with a wax wafer bite registration and opposing arch alginate impression. From this, the laboratory was able to use a standard implant abutment (Figs 1 & 2) and fabricate a metal alloy bonded to porcelain crown.

The laboratory work was fabricated on a plaster model (Figs 3, 4 and 5) with a soft tissue representation. The crown was cement retained and the abutment screw retained. The surgical implant placement was central and allowed axial loading of the fixture and also a favourable gingival profile.

The components were then transferred from the laboratory model (Fig 6). The abutment was tightened to 35NM and the crown cemented with a zinc Oxide/Eugenol based cement.

The final result produced an aesthetically predictable restoration (Figures 7 &8). A Straumann implant was favoured in this case as it required a simple placement protocol and the aesthetic work was carried out entirely within the laboratory. No abutment preparation was required with this system, making restoration simpler and producing good aesthetics.